[Prevention and treatment of necrotizing enterocolitis in the newborn infant from the pediatric point of view].
1. Enteral feeding and factors promoting hypoxia and ischaemia of the gut are thought to cause necrotising enterocolitis of the newborn but have not been proven as factors in the pathogenesis of NEC. Enteral feeding may be started in principle on the first day of life at a rate of 10-20 ml/kg/day. Controlled results to the contrary have not been published. 2. Drugs which have a high osmolarity should be diluted with milk as far as possible to avoid mucosal damage. 3. In cases of epidemic NEC, infants with proven disease should be isolated. The use of a bactericidal and virucidal disinfectant is imperative for hand disinfection. 4. Early diagnosis and early treatment are necessary to prevent progression to advanced stages. 5. Antibiotic treatment should be selected to cover the entire bacterial spectrum of the ward. 6. Frequent physical, radiological and ultrasound examinations should be done to monitor the course of the disease. Laboratory analyses should include: acid-basis status, leukocytes, differential blood picture, thrombocytes, C-reactive protein, haematocrit, serum electrolytes. 7. Large amounts of fluid may be necessary to prevent and treat hypovolaemic shock. 8. Abdominal paracentesis helps to recognise peritonitis and intestinal gangrene and allows surgical treatment as early as possible.
Pohlandt
F
F
Gemeinsame Einrichtung für Neonatologie und pädiatrische Intensivmedizin der Universitäts-Kinderklinik Ulm.
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004761:Enterocolitis, Pseudomembranous / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D012307:Risk Factors
D000900:Anti-Bacterial Agents
Prophylaxe und Behandlung der nekrotisierenden Enterokolitis des Neugeborenen aus pädiatrischer Sicht.